| Objective: ERAS aims to accelerate the recovery of patients after surgery,reduce the stress caused by surgery,the incidence of complications and shorten the postoperative hospital stay.We design the perioperative process of breast cancer by applying the concept of rapid rehabilitation surgery,and compare it with the traditional perioperative process of breast cancer,and analyze the two different perioperative processes on postoperative inflammation indicators,complications,and recovery quality of patients Changes in the score(QOR-40)to evaluate whether the rapid rehabilitation process for breast cancer surgery patients can reduce postoperative stress and trauma and speed up body recovery.Methods: We admitted 96 patients with breast cancer who underwent pathological biopsy in our hospital from September 2019 to January 2020,of which 54 patients with breast cancer surgery entered the accelerated rehabilitation surgery recovery process(ERAS group),and 42 patients with breast Cancer surgery patients were compared by traditional postoperative recovery methods.We analyzed and compared the C-reactive protein and interleukin at 24 hours and 72 hours after the operation of the two groups of patients and according to different surgical methods(total resection + sentinel,total resection + axillary clearance,breast preservation + sentinel,breast preservation + axillary clearance).The difference between 6 and Clavien-Dindo classification was used to classify the complications in the Kuaikang group and the traditional group.The complications were collected within one month after the operation.The independent sample t test method was used to observe and compare the levels of c-reactive protein and interleukin-6 at 24 hours and 72 hours after operation in the two groups of patients.The two groups of patients were followed up for one month after the operation.The differences in the incidence of postoperative complications among patients with traditional postoperative recovery methods were compared.And on the third day after the operation,the patients evaluated the QOR-40 scale by themselves,and observed whether the QOR-40 score of the Kuikang group was better than the traditional group.Results: 1.Comparison of age,weight,height,tumor size and operation method between the two groups of patients,p>0.05,no significant difference was found,the difference was not statistically significant,the difference in operation time,p<0.05 difference was statistically significant.2.Changes in inflammation indicators: Comparison of the levels of high-sensitivity C-reactive protein(CRP)between the Kuaikang group and the traditional group: Comparison of preoperative CRP levels,the Kuaikang group was 1.21 ± 1.22,the traditional group was 1.40 ± 1.20,P>0.05,no statistics Significantly,the comparison of CRP levels in the 24-hour postoperative period was 7.32 ± 4.26 in the Kangkang group and 24.57 ± 10.45 in the traditional group,P<0.05,the difference was statistically significant,and the CRP level at72 hours after the operation was 22.40± 20.10,the traditional group was 38.75±27.63,P<0.05,the difference was statistically significant;the comparison of the interleukin-6(IL-6)level between the Kuaikang group and the traditional group: the preoperative IL-6 level comparison,the Kuaikang group was 2.07±1.56,the traditional group was 1.88±0.91,P>0.05,no statistical significance,the comparison of IL-6 levels at 24 hours after operation,the fast-kick group was 18.55 ± 13.54,the traditional group was 29.26 ± 13.37,P<0.05,the difference was Statistically,the IL-6 levels at 72 hours after operation were10.54±9.33 in the Kuikang group and 11.66±8.86 in the traditional group,P>0.05,and the difference was not statistically significant.Different surgical methods: comparison between patients in Kuaikang group and traditional group: 1.Total breast resection + sentinel: CRP: CRP in the Kuaikang group was 0.70±0.66,CRP in the traditional group was 1.18±0.84,P>0.05,no difference Statistically,the CRP of the 24-hour postoperative CRP was 5.15±4.11,the CRP of the traditional postoperative group was 24.04± 7.83,P<0.05,the difference was statistically significant,and the 72-hour postoperative CRP of the Kuikang group was 14.16 ± 11.88,72 hours postoperative CRP of the traditional group was 31.24 ± 31.23,P>0.05,the difference was not statistically significant,IL-6: the preoperative IL-6 of the Kuaikang group was 1.79±0.91,and the traditional group of IL-6 was 1.89 ±0.72,P>0.05,the difference was not statistically significant,the IL-6 of the24-hour postoperative group was 15.27±5.21,the IL-6 of the traditional group after 24 hours was 26.58± 19.57,P>0.05,the difference was not statistically significant Significance,IL-6 was 8.46±4.63 at 72 hours postoperatively in the Kuaikang group and 11.96±13.20 at 72 hours postoperatively in the traditional group,P>0.05,the difference was not statistically significant;2.Total breast excision + armpit clear: CRP: The preoperative CRP was 1.47 ± 1.62 in the Kuaikang group,and the preoperative CRP was 1.05 ± 0.63,P>0.05 in the traditional group.The difference was not statistically significant.The CRP in the Kuaikang group was 7.60±4.02 at 24 hours postoperatively.The 24-hour CRP was 24.57±11.64,P<0.05,and the difference was statistically significant.The72-hour postoperative CRP of the Kuaikang group was 21.76±24.57,and the traditional group ’ s 72-hour postoperative CRP was 32.77 ± 23.63,P>0.05.There was no statistical difference Significance of study,IL-6: preoperative IL-6was 2.33 ± 1.98 in the fast-knowing group,and 2.03 ± 1.39 was IL-6 in the traditional group,P>0.05,the difference was not statistically significant.-6 was20.65±15.53,IL-6 was 28.75±8.88 in the traditional group at 24 hours after operation,P>0.05,the difference was not statistically significant,IL-6 was 8.73±8.64 at 72 hours after operation in the Kuaikang group,after operation in the traditional group 72 hours IL-6 was 10.14±5.99,P>0.05,the difference was not statistically significant.3.Breast-conserving + sentinel: CRP: the preoperative CRP was 1.38 ± 1.13 in the Kangkang group and 1.29 ± 0.57 before the operation in the traditional group,P>0.05,the difference was not statistically significant.Was 9.17±4.42,the CRP of the traditional group was 31.68±13.62 at 24 hours after operation,P<0.05,the difference was statistically significant,the CRP of the 72 hours after operation in the Kuikang group was 30.93±18.60,and the CRP of the traditional group was 59.08± at 72 hours after operation.21.19,P<0.05,the difference was statistically significant,IL-6: the preoperative IL-6 was 2.08±1.69 in the Kuaikang group,the preoperative IL-6 was 1.63±0.30 in the traditional group,P>0.05,the difference was not statistically significant,IL-6 was 21.48±16.22 at 24 hours postoperatively in the Kuikang group,36.32±15.95 at 24 hours postoperatively in the traditional group,P>0.05,the difference was not statistically significant,IL-6 at 72 hours postoperatively in the Kuikang group Was 15.45 ± 11.95,72 hours after operation in the traditional group,IL-6 was 16.18 ± 9.79,P>0.05,the difference was not statistically significant;4.Breast-conserving excision + axillary clear: CRP:CRP of 0.91 ± before surgery 0.41,the preoperative CRP of the traditional group was 2.06±1.86,P>0.05,the difference was not statistically significant,the CRP of the Kuaikang group after 24 hours was 5.45±2.95,the CRP of the traditional group after 24 hours was 22.04±9.31,P<0.05 The difference was statistically significant.The 72-hour postoperative CRP of the Kuaikang group was 16.38±15.02,and the 72 hours postoperative CRP of the traditional group was 44.02 ± 29.26,P<0.05.The difference was statistically significant.IL-6:Kuaikang group The pre-IL-6 was 1.82±0.55,the traditional group IL-6 was1.78±0.38,P>0.05,the difference was not statistically significant,the 24-hour postoperative IL-6 was 10.85±4.76,and the traditional group was postoperative The IL-6 at 24 hours was 29.21±11.43,P<0.05,the difference was statistically significant.The IL-6 at the 72 hours postoperatively in the Kangkang group was6.84±5.15,and the IL-6 at 72 hours after the traditional group was 11.42±7.55,P >0.05,the difference is not statistically significant;3.The incidence of complications: 54 cases in the Kuikang group,6 cases in total,42 cases in the traditional group,12 cases in total,compared between the two groups,P=0.029,the difference is statistically significant;Complications were compared according to the Clavien-Dindo classification: the comparison of grade I complications,4 cases occurred in the Kikang group,and 9 cases occurred in the traditional group,p=0.046,the difference was statistically significant,the comparison of grade II complications,Kikang 1 case occurred in the group,1 case occurred in the traditional group,p=0.857,the difference was not statistically significant,compared with the complication of grade IIIa,1 case occurred in the Kuaikang group,2 cases occurred in the traditional group,p=0.416,the difference was not statistically significant.4.Recovery quality score(QOR-40): The average QOR-40 score on the third day after operation in the Kangkang group was 174.33±14.35,and the average QOR-40 score on the third day after surgery in the traditional group was169.26±16.11,compared between the two groups,P=0.107,The difference was not statistically significant.Comparing the five dimensions of the QOR-40 scale between the Kuikang group and the traditional group,the body comfort was obtained: the Kuikang group was 50.80±6.12,the traditional group was 48.48±5.06,the comparison between the two groups,p<0.05,See significant differences;pain control: 30.46±2.95 in the Kuikang group,28.55±2.89 in the traditional group,compared between the two groups,p<0.05;physical condition: 39.30 ± 4.25 in the Kuikang group,38.60±5.51 in the traditional group,Comparison between the two groups,p>0.05,no significant difference;patient support: Kuikang group was 30.46±3.28,traditional group was 30.07±2.87,compared between the two groups,p>0.05,no significant difference;In terms of self-care ability: the Kuikang group was 22.94± 1.85 and the traditional group was 23.40±2.37.Compared between the two groups,p>0.05,no significant difference was found.Conclusion: Analysis shows that applying the concept of accelerated rehabilitation surgery to design breast cancer perioperative procedures enables patients to reduce postoperative inflammation indicators,reduce postoperative stress response of breast cancer patients,and reduce the overall postoperative complications and stage I complications of patients The incidence rate,and can improve and improve the quality of postoperative recovery of breast cancer patients,speed up the postoperative recovery of patients. |
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